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Surgical Science 2016年第8期7卷 357-360页

作者： Haithem Zaafouri Anis Hasnaoui Raja Jouini Dhafer Haddad ahmed Bouhafa Anis Ben Maamer Department of Surgery Habib Thameur Hospital Tunis Tunisia Department of Histopathology and Cytology Habib Thameur Hospital Tunis Tunisia

Collision tumors of adenocarcinoma and MALT (Mucosa-associated lymphoid tissue) lymphoma are often rare findings of resection specimens of gastric carcinomas. The fact that these two histological lesions are contiguous may suggest a common oncogene. As it is widely known, Helicobacter pylori (H. pylori) plays a leading role in gastric oncogenesis. Could it be responsible for these tumors? As of today, the exact mechanism is still unclear. However, some histological findings may suggest that H. pylori promotes the formation of MALT lymphoma which increases the risk of carcinomatous changes. Prognosis of collision tumors is tightly linked to the carcinoma lesion, which is generally poor due to diagnostic delay. Large scale strategies to eradicate H. pylori and detect early lesions could reduce the mortality of this disease.

关键词： Collision Tumor Gastric Lymphoma Adenocarcinoma Helicobacter pylori

Primary cancers of the small bowel: About 20 cases

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Open Journal of Gastroenterology 2014年第2期4卷 81-87页

作者： Noomen Haoues Manel Mabrouk Haithem Zaafouri Rabii Noomene ahmed Bouhafa Anis Ben Maamer Abderraouf Cherif Department of General Surgery Habib Thameur Hospital Tunis Tunisia

Background: Cancers of the small bowel are rare. Diagnosis is late and difficult because of the lack of specific signs. Treatment is surgical. Prognosis is usually poor and depends on the histological type of tumor. Aim of Study: To specify the epidemiological, clinical and therapeutic characteristics of small bowel primary cancers in order to improve their prognosis. Material and Methods: This is a retrospective study about 20 cases of malignant tumors of the small bowel, collected in the department of general surgery of habib Thameur Hospital in Tunis (Tunisia), from January 1994 through June 2011. Results: Our series involved 11 women and 9 men aged 62 on average (range: 44 - 80 years). In 45% of cases, the diagnosis was made in a patient rushed to hospital with clinical features of acute generalized peritonitis (66% of all surgical emergencies). Intestinal transit was performed in 5 patients only. Ultrasound abdominal examination was performed in 11 patients. Abdominal CT scan was performed in 7 patients, but the results were conclusive in 4 cases only (57%). Small bowel scanning was done in 5 patients only, but led to a positive diagnosis in all of them. All of our patients underwent surgery. Tumors of the small bowel were histologically divided as follows: carcinoid tumor (8 cases), leiomyosarcoma (7 cases), giant B-cell lymphoma (2 cases), malignant stromal tumor (2 cases) and malignant myxoid schwannoma (1 case). Malignant tumors of the small bowel most commonly arise in the ileum (60%) followed by the jejunum (35%). As for the long-term course, there was a recurrence at one year of a leiomyosarcoma and two recurrences of stromal tumors associated with liver metastases. Conclusion: Small bowel cancers are rare. Time to consultation is long and diagnosis is difficult and late due to the absence of typical presentation. Treatment is surgical and progression depends essentially on histological findings.

关键词： Primary Cancers Small Bowel Epidemiology Diagnosis

Knowledge and awareness of infection control practices among nursing professionals:A cross-sectional survey from South Asia and the Middle East

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World Journal of Critical Care Medicine 2023年第3期12卷 176-187页

作者： Kanwalpreet Sodhi Gunjan Chanchalani Muktanjali Arya Gentle S Shrestha Juhi N Chandwani Manender Kumar Monika G Kansal Mohammad Ashrafuzzaman Anushka D Mudalige Ashraf Al Tayar Bassam Mansour Hasan M Saeed Madiha Hashmi Mitul Das Nehad N Al Shirawi Ranjan Mathias Wagih O ahmed Amandeep Sharma Diptimala Agarwal Prashant Nasa Department of Critical Care Deep HospitalLudhiana 141001PunjabIndia Critical Care Medicine Somaiya Hospital and Research CentreMumbai 400001MaharashtraIndia Department of Microbiology and Infection Control Deep HospitalLudhiana 141001India Department of Critical Care Medicine Tribhuvan University Teaching HospitalKathmandu 44600Nepal Anaesthesia and Intensive Care Unit Royal HospitalMuscat 112Oman Department of Cardiac Anaesthesia Fortis HospitalLudhiana 141002PunjabIndia Intensive Care Medicine Ng Teng Fong General HospitalSingapore 609606Singapore Intensive Care Unit Bangabandhu Sheikh Mujib Medical UniversityDhaka 1000Bangladesh Intensive Care Unit Colombo North Teaching HospitalRagama 11010Sri Lanka Intensive Care Unit and Respiratory Therapy Department Security Forces HospitalDamman 34223Saudi Arabia Pulmonary and Critical Care Division Zahraa Hospital-University Medical CenterBeirut 1007Lebanon Pulmonary Division Faculty of Medical SciencesLebanese UniversityBeirut 1007Lebanon Department of Critical Care Salmaniyah Medical ComplexManama 323Bahrain Department of Critical Care Medicine Ziauddin UniversityKarachi 75530Pakistan Anaesthesia and Critical Care Swasti HospitalRangia 781354India Department of Critical Care Medicine Al Fujairah HospitalFujairah 0000United Arab Emirates Department of Anesthesia and Intensive Care Hamad Medical CorporationDoha 974Qatar Intensive Care Unit Sulaiman Al Habib Medical GroupBuraidah 52211Saudi Arabia Department of Nursing Deep HospitalLudhiana 141001India Anesthesia and Intensive Care Shantived Institute of Medical SciencesAgra 282007India Department of Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Internal Medicine College of Medicine and Health SciencesAl Ain 15551Abu DhabiUnited Arab Emirates

BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated *** To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC *** An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three *** A total of 1333 nurses from 13 countries completed the *** average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ***,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of *** in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among *** There is considerable variation in knowledge among nurses working in *** like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.

关键词： Knowledge Attitude Policy compliance Infection control Infection control practices Nurses

Anticoagulation in Pregnant Women with Mechanical Heart Valve Prostheses: 25-Year Experience at a Tertiary Care Hospital in a Developing Country

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World Journal of Cardiovascular Diseases 2014年第6期4卷 287-293页

作者： ahmed Tounsi Dorra Abid Doulira Louati Souad Mallek Malek Akrout Leila Abid Mohamed Abdennadher Imed Frikha Kais Chaabene Mourad Hentati Samir Kammoun Cardiology Department Hedi Chaker Hospital Sfax Tunisia Department of Cardiovascular Surgery Habib Bourguiba Hospital Sfax Tunisia Obstetrics and Gynecology Department Hedi Chaker Hospital Sfax Tunisia

The aim of this retrospective study was to compare the different anticoagulation regimens used in pregnant women with prosthetic heart valves. We reviewed 86 pregnancies in 57 women from 1987 to 2011. The patients were divided into two groups: group A (39 pregnancies) had oral acenocoumarol throughout pregnancy;and in group B (47 pregnancies), acenocoumarol was replaced by subcutaneous heparin during the first trimester. Both groups received heparin at the time of delivery. The valves replaced were mitral (59.65%), aortic (12.28%), or both (28.07%). 74 pregnancies (86.04%) resulted in live births, 9 (10.46%) had stillbirths, 1 (1.16%) had spontaneous abortion and 2 (2.32%) underwent therapeutic abortions. The live birth rate was higher in women on heparin (87.23%) compared with those on acenocoumarol (84.61%). No malformations appeared in the 74 newborns, except for one case of hydrocephalus. There was one maternal death due to acute mitral valvular thrombosis while on heparin in the first trimester. Hemorrhagic complications occurred in 13 patients in the postpartum period, 4 of whom required transfusion. No anticoagulant regimen can be said to be entirely safe for use during pregnancy as there is a degree of risk with each regimen. Heparin does not offer a clear advantage over oral anticoagulation in the pregnancy outcome.

关键词： Anticoagulation Pregnancy Mechanical Heart Valve Prostheses Maternal Complications Heparin Acenocoumarol